Computer Guided Versus Conventional Arthrocentesis in Management of Internal Derangements: A Randomized Clinical Study

Inclusion Criteria: * Patients who complain from signs and symptoms of internal derangements and were diagnosed by the RDC/TMD as having disc displacement with/ without reduction with / without limitation associated with arthralgia or as having disc displacement with reduction associated with arthralgia in a presence or absence of joint sounds. * Patients who did not responded to conservative treatment for a minimum of 3 months. * Obtaining written informed consents signed by the patients. Exclusion Criteria: * Patients suffering from any muscular disorders as myofascial pain or myofascial pain with limitations * If the disc was not visible in the MRI examination. * Patients who previously received intra-articular injection of any medication or exposed to any other TMJ invasive procedure. * Patients who suffer from any connective tissue diseases as rheumatoid arthritis or neurologic disorders. * Patients with history of major jaw trauma, bisphosphonate-derived drug use, pregnancy, alcohol or drug dependence. * Patients with gross mechanical restrictions or history of adhesion (fibrous or bony). * Patients with psychiatric disease or substance abuse or have an allergy to the substance used in the study.